Monday, July 28, 2014

Part-time ambulance to be eliminated from city

From page A1 | October 15, 2012 |

Unit 26, a part-time ambulance unit serving the city of Placerville, will be eliminated from service, likely sometime in December or January said Marty Hackett, executive director of El Dorado County Emergency Services Authority.

At Tuesday’s Placerville City Council meeting, councilmembers heard a presentation from Hackett, Georgetown Fire Chief Greg Schwab and El Dorado County Fire Chief Mike Hardy.

The eight full-time and one part-time ambulance that serve El Dorado County are part of a county-wide organization or Joint Powers Authority (JPA), that is governed by a board composed of the fire chiefs from each of the 10 fire districts in the county. Escalating costs and declining revenues attributed to reductions in the number of calls and increasing numbers of Medicare and Medi-Cal patients have caused a budget deficit of $1.1 million.

Despite cost-cutting measures and the labor concessions that will save $300,000, a shortfall of $600,000 is anticipated and elimination of the part-time unit will save approximately $660,000, enough to balance out the 2013-2014 budget said Hackett.

“We’ve been seeing this situation for two years,” said Chief Schwab, chairman of the JPA. “We’ve gone out to bid to reduce costs, partnered with other fire districts, switched from linens to disposable materials and recycled our ambulances rather than purchase new ones.We’re in the business of serving the public, but we’ve made every other cut we can and we are deep into our reserves. We can spread this out with our other units.”

Unit 26 is stationed in Camino, but operates out of Placerville due to the number of calls, averaging 3.3 calls a day. It is dedicated to inter-facility transfers — from Marshall Hospital to nursing facilities or to hospitals in Sacramento, Roseville or even San Francisco.

A possible increase in emergency response times was the concern of City Council and members of the public, an issue Hackett has already addressed with the JPA. “We are implementing changes to our system status management to mitigate any loss of response time and will utilize “call-backs” to call in off duty staff to do transport or fill in if we only have two or three units available. All eight of our units serve the entire system. The  city is the core of the system because it has the highest number of calls, so it is always covered,” Hackett said.

By contract with the county, ambulance services are required to required to meet the following maximum response times at least 90 percent of the time: urban areas —11 minutes; semi-urban areas — 16 minutes; rural areas — 24 minutes; and wilderness areas — 90 minutes. For the past 43 months, the JPA has met those standards 94 percent of the time for urban areas, 93 percent for semi-urban, 92 percent for rural and 100 percent for wilderness areas.

“We always met that response time in the past year,” said Hackett, “and almost always over the past four years and we are very proud of that.”

Councilman Carl Hagen said,”There may be some slow down in service. The primary funding source for this is our ambulance tax and the county has healthy reserves that could be used to backfill the deficit.”

Medicare and Medi-Cal do not pay the full cost of ambulance services and with an increasing number of people in the community becoming Medicare and Medi-Cal patients, the loss last year was $300,000 to $400,000 said Hackett. “Some supplemental Medi-Cal monies might be coming, but we can’t count on it.”

Response times will be closely monitored with a monthly statistical report which Hackett said he would provide to the City Council. Unit 26 won’t be mothballed, instead, it will become part of the fleet in regular rotation with the rest of the ambulances.

Interfacility transfers will be handled by the other eight units in rotation, with a”move up and cover” system in place to provide coverage for the ambulance unit while doing a transfer.

Schwab said JPA analysis of the impact of eliminating Unit 26 indicated that 1.5 additional calls would have to be absorbed by the other Medic Units. “That is very manageable.”
“Marshall Hospital has a new Level III Trauma Center opening. What if there are a lot more calls?” asked vice mayor Wendy Mattson.

“A Level III Trauma Center is an aid to us,” said Schwab. “We don’t have to transfer so many people and the Emergency Room is larger. Because we have a trauma center doesn’t mean we’ll have more calls.”

Hardy, the lone dissenting vote on the JPA against eliminating the unit, said, “This will impact firefighting since the paramedics are also firefighters. If just one transfer call removes a unit for 4-5 hours a day, we will need a very robust ‘move up and cover’ system to provide coverage.”

Councilwoman Patty Borelli questioned the need for both fire engines and medic units to response to every call. “Sometimes it may appear to be one type of call, but then things worsen and both units are needed,” said Hackett. “That will be changing; as of Oct.1, we are trying not to send both units if not needed.

“We’re hoping that with the modifications to the system plan and using call backs, this will not affect the 9-1-1 system ,” said Hackett.”We want to benefit as many as we can with the fewest impact of the cuts. We will monitor our response times and if we can’t meet them, we’ll have to find another alternative.”

City Council took no action with regard to the Unit 26 elimination which needs a second approval by the JPA and by El Dorado County Emergency Medical Services before becoming effective in December or January.

Contact Wendy Schultz at 530 344-5069 or Follow @wschultzMtDemo on Twitter.





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